The hospital provider business model has traditionally focused on maximizing revenue through increased inpatient utilization, where the focus was primarily on curative care in the remedial treatment of diseases or physical disorders. In the post-Affordable Care Act era, health care is rapidly moving toward complete clinical integration across the continuum of patient care, with a focus on prevention and creating healthier communities in addition to the more traditional therapeutic measures. Extending the continuum of care beyond the hospital requires the collaborative efforts of many stakeholders, including hospitals, physicians and other allied service providers, such as skilled nursing homes and home health providers. To build a sustainable infrastructure to appropriately respond to these changes in the health care industry requires access to capital, technology and expertise.

The successful health care delivery model of the future will be built around population health and will focus on quality outcomes and value, rather than sheer volume. As responsible boards of directors explore whether their institutions can go it alone, they should explore alternative delivery models with strategic partners that may better position their organizations and communities to face the new challenges and opportunities associated with population health management. During these deliberations, many boards will consider merging with other providers, while wrestling, rightfully, with the possibility that, if they succumb to the urge to merge, they may very well surrender critical care access to their service communities and significantly compromise their charitable mission in the process.